Dr. Paul Donohue Good Health

DR. PAUL DONOHUE GOOD HEALTH

July 22, 2004|DR. PAUL DONOHUE GOOD HEALTH

Dear Dr. Donohue: My son lives three states away from his father and me. He is 27 and has been on his own since graduating from college four years ago. He called us to tell us he might have SBE. What is it? How serious is it? -- R.V.

Dear R.V.: "SBE" stands for subacute bacterial endocarditis, an infection of one of the four heart valves. Most often, the involved valve is one that has been deformed by some prior condition, like rheumatic fever.

Bacteria constantly get into the blood. The body disposes of them easily. However, when bacteria see a deformed heart valve, they home in on it and begin to multiply. They have found a safe haven. Soon, they further damage an already-damaged valve, and that can lead to heart failure.

SBE is a condition that requires hospital treatment. Antibiotics must be given through a vein to attain high blood levels rapidly in order to stop the bacterial proliferation on the valve. It can take a month or more of treatment to eradicate the infection.

Your son's doctor will not be wasting any time in confirming the diagnosis. Your son's blood will be checked for any bacteria that might be in it -- one important sign of this infection.

Echocardiograms -- sound wave pictures of the heart and its valves -- can disclose a deformed valve and the bacteria that are growing on it.

Most of the time, treatment for SBE turns out well. In spite of antibiotic treatment, your son could face repair of the damaged heart valve.

For completeness' sake, I had better mention acute bacterial endocarditis. It too is a heart valve infection, but the infection takes place on a normal valve. Acute bacterial endocarditis is a greater health menace than is the subacute variety.

Dear Dr. Donohue: Is it possible to become addicted to caffeine? I drink 10 cups of coffee every day. I have tried to stop, but when I do, I become sluggish and get a headache. Is that a sign of addiction? -- W.W.

Dear W.W.: Caffeine can be slightly habit-forming. Abruptly stopping heavy use can bring on headaches and lethargy. They can be avoided by gradually tapering the amount of caffeine drunk.